Modelling and Simulation of a River-Crossing Operation via Discrete Event Simulation with Engineering Details

From a military standpoint, a river is an area that should be avoided in a potential engagement because of lack of cover and the necessity of dividing the unit while crossing. Thus, a key point of a river-crossing operation is speed. Many efforts have been made to enable faster river crossing by improvement of tactics, techniques, and procedures (TTP). However, improvements in TTP are evaluated by modelling and simulation much less frequently than are the toe-to-toe engagements between two opposing forces, and to our knowledge, this is the first simulation model of brigade-level river crossing with engineering details. This study presents a simulation model of the river-crossing operation, applies real world parameters, and evaluates which tactics are preferable in a particular operational environments. This analysis has led to new operational methods of river crossing that have been suggested by experienced subject-matter experts. For instance, the current Republic of Korea Army Field Manual dictates to rotate river-crossing rafts in all situations, but our experiment suggests that no rotation is preferable when the width of river is less than 400 m based on the statistical analyses, which includes the regression-based meta-modelling and the ANOVA, of our simulation model that embodies the engineering details of river-crossing equipment.Defence Science Journal, Vol. 65, No. 2, March 2015, pp.135-143, DOI:http://dx.doi.org/10.14429/dsj.65.814

Characteristics of blood tests in patients with acute cerebral infarction who developed symptomatic intracranial hemorrhage after intravenous administration of recombinant tissue plasminogen activator

Objective Patients suspected as having acute ischemic stroke usually undergo blood tests, including coagulation-related indexes, because thrombocytopenia and coagulopathy are contraindications for recombinant tissue plasminogen activator (rtPA) administration. We aimed to identify blood test indexes associated with symptomatic intracranial hemorrhage (sICH) in patients with acute ischemic stroke who received intravenous rtPA. Methods This retrospective observational study included patients diagnosed with acute ischemic stroke who were treated with intravenous rtPA at the emergency department of a tertiary hospital in Seoul between February 2008 and January 2018. Blood test indexes were compared between the sICH and non-sICH groups. Logistic regression and receiver-operating characteristic curve analyses were performed. Results In this study, 375 patients were finally included. Of 375 patients, 42 (11.2%) showed new intracranial hemorrhage on follow-up brain computed tomography, of whom 14 (3.73%) had sICH. Platelet count, aspartate aminotransferase and lactate dehydrogenase levels were significantly different between the sICH and non-sICH groups, and platelet count showed statistical significance in the regression analysis. Significantly lower platelet counts were observed in the sICH group than in the non-sICH group (174,500 vs. 228,000/mm3, P=0.020). The best cutoff platelet count was 195,000/mm3, and patients with platelet counts of <195,000/mm3 had a 5.4- times higher risk of developing sICH than those with platelet counts of ≥195,000/mm3. Conclusion Platelet count was the only independent parameter associated with sICH among the blood test indexes. Mild thrombocytopenia may increase the risk of sICH after intravenous administration of rtPA